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NPI Code Detail

MEDICARE: MR. LON NICHOLAS KEYES R.PH.

MEDICARE: MR. LON NICHOLAS KEYES R.PH.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist26016064AIN

General Provider Information

NPI Number : 1427040807
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LON NICHOLAS KEYES R.PH.
Provider Business Mailing Address
First Line : 416 E MAUMEE ST
Second Line :
City : ANGOLA
State : IN
Zip : 46703-2015
Country : US
Telephone Number : 260-665-2141
Fax Number : 260-665-7888
Provider Business Practice Location Address
First Line : 416 E MAUMEE ST
Second Line :
City : ANGOLA
State : IN
Zip : 46703-2015
Country : US
Telephone Number : 260-665-2141
Fax Number : 260-665-7888
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2005
Last Update Date : 07/10/2007

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